Internalizing Symptoms Mediate the Relation Between Acute Pain and Autism in Adults.

Wormald et al. (2019) asked why autistic adults with intellectual disability show strong pain behaviors.

They measured autism traits, anxiety, depression, and pain reactions in one group.

The team then used statistics to see if mood explained the autism-pain link.

Adults with more autism traits showed more pain behaviors.

Anxiety and depression carried part of this link.

In plain words, mood made the pain response worse.

Hwang et al. (2020) and Sutton et al. (2022) extend the story. They show that intolerance of uncertainty also feeds anxiety in autistic people.

MacLennan et al. (2021) and Storch et al. (2012) are early-life previews. They found that sensory over-responsivity in toddlers and preschoolers predicts later anxiety, hinting that the mood-pain loop starts young.

Krzysztofik (2026) used the same simple pre-post style during COVID. Uncertainty spiked sensory issues and stress in autistic kids, echoing the adult mood-pain pattern.

Before any shot, dental work, or blood draw, run a quick mood check. Ask about worry, sadness, or recent meltdowns. If scores are high, add extra supports: noise-canceling headphones, a favorite item, or a brief coping script. Easing anxiety or depression may cut the pain reaction you see in session.